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Almost home : reforming home and community care in Ontario /
"Almost Home is a comprehensive study of the policy questions underlying the shift in medical care from hospitals to homes and communities, a change that is reshaping Canadian health care policy and politics. Using document analysis and interviews with government officials and other key stakeho...
| Clasificación: | Libro Electrónico |
|---|---|
| Autor principal: | |
| Otros Autores: | , |
| Formato: | Electrónico eBook |
| Idioma: | Inglés |
| Publicado: |
Toronto ; Buffalo :
University of Toronto Press,
©2004.
|
| Temas: | |
| Acceso en línea: | Texto completo |
Tabla de Contenidos:
- 1. Introduction and overview
- 1.1 From hospital to home and community
- 1.1.1 The medicare mainstream
- 1.1.2 Outside the mainstream: community-based long-term care
- 1.1.3 Policy content: financing, delivery, and allocation
- 1.2 The case of Ontario's reform of community-based long-term care
- 1.2.1 Factors pushing towards reform
- 1.2.2 Models for reform
- 1.3 Looking ahead: the making and meaning of LTC reform in Ontario
- 2. Conceptual framework
- 2.1 Introduction
- 2.2 Neo-institutionalism and policy communities
- 2.2.1 Ideas
- 2.2.2 Institutions
- 2.2.3 Interests
- 2.3 Policy outcomes: design decisions
- 2.3.1 The public/private mix
- 2.3.2 Financing
- 2.3.3 Delivery
- 2.3.4 Allocation
- 2.4 Summary and conclusions: policy legacy
- 3. Research methodology: the case study approach
- 3.1 Qualitative research and case studies
- 3.2 Data sources
- 3.2.1 Documents
- 3.2.2 Interviews
- 3.3 Determination of the policy community
- 3.4 The community-based LTC policy community
- 3.5 Analytical strategies
- 3.5.1 Historical review
- 3.5.2 Policy analysis
- 3.5.3 Content analysis
- 4. Long-term care reform in the Liberal period, 1985-1990
- 4.1 Long-term care reform under the Liberal governments
- 4.2 Liberal minority government, 1985-1987: one-stop shopping
- 4.2.1 Institutional changes and underlying government interests
- 4.2.2 A new agenda
- 4.2.3 Societal interests and influence on reform
- 4.2.4 Assessment of one-stop access by members of the policy community
- 4.3 Liberal majority government, 1987-1990: service access organizations
- 4.3.1 Paradigm shift through institutional change
- 4.3.2 MCSS takes charge
- 4.4 Rationale for and scope of the reform
- 4.4.1 Strategies for cange and the service access organizations
- 4.4.2 Service access organizations
- 4.4.3 Integration of services through institutional change
- 4.4.4 Influence of societal interests on the development of the SAO model
- 4.4.5 The mobilization of interests
- 4.4.6 Assessment of SAO by the LTC policy community
- 4.4.7 Beginning of the implementation process for strategies for change
- 4.5 Conclusions.
- 5. Long-term care reform under the New Democratic Party, 1990-1993
- 5.1 The first attempt at long-term care reform under the New Democratic Party
- 5.2 The early days of the NDP government, 1990-1992: delay, then more of the same
- 5.2.1 Redirection and the service coordination agency model
- 5.2.2 Service coordination agency: a Liberal model in NDP clothing?
- 5.2.3 Consultation with the community
- 5.2.4 Mobilization of interests
- 5.2.5 The coalitions propose a new model
- 5.2.6 Institutional changes within government: the shift from MCSS to MOH
- 5.2.7 A new model begins to emerge
- 5.3 The NDP and the multi-service agency model
- 5.3.1 The recession and the social contract
- 5.3.2 The locus of policy development shifts
- 5.3.3 The partnership documents
- 5.3.4 Anticipating objections
- 5.4 Conclusions
- 6. The New Democratic government and the multi-service agency, 1994-1995
- 6.1 The New Democrats and the multi-service agency
- 6.2 Bill 173, an Act respecting long-term care
- 6.3 Government interests
- 6.3.1 Direct delivery
- 6.3.2 Human resource issues: unionization and protection of collective agreements
- 6.3.3 For-profit versus non-for-profit delivery
- 6.3.4 External purchase of services
- 6.3.5 Mandated basket of services
- 6.3.6 Entitlement to home care
- 6.3.7 User fees
- 6.4 Policy interests of societal groups
- 6.4.1 'Consumers'
- 6.4.2 Providers
- 6.4.3 Labour
- 6.4.4 Volunteers
- 6.4.5 Other interests
- 6.4.6 Activities of the provider coalition
- 6.5 A babel of values
- 6.6 Amendments to Bill 173
- 6.7 Perceived influence of societal interest groups
- 6.8 Conclusions
- 7. The Progressive Conservatives implement long-term care, 1995-1996
- 7.1 The Progressive conservatives
- 7.2 The Progressive Conservatives on campaign
- 7.3 The Progressive Conservatives and the community care access centres
- 7.3.1 The PC consultation
- 7.3.2 The consultation report
- 7.3.3 Assessment of the consultations
- 7.3.4 The CCAC model
- 7.3.5 Assessment of CCACs
- 7.4 Government interests in the development of the CCAC model
- 7.5 Societal interets
- 7.5.1 Changing structure of societal groups
- 7.5.2 Interests advanced by societal groups at the consultation
- 7.6 Influence of interests
- 7.7 Conclusions
- 8. Moving towards home: policy change and policy stasis beyond the medicare mainstream
- 8.1 Reforming community -based long-term care in Ontario
- 8.2 Summary: policy content and process under successive governments
- 8.2.1 One-stop shopping/access (Liberal, 1987)
- 8.2.2 Service access organizations (Liberal, 1990)
- 8.2.3 Service coordination agency (NDP, 1991)
- 8.2.4 Multiservice agencies (NDP, 1993)
- 8.2.5 Community care access centres (PC, 1996)
- 8.2.6 Summary of the reform models
- 8.3 Ideas, interests, and institutions
- 8.3.1 Ideas
- 8.3.2 Interests
- 8.3.3 Institutions
- 8.4 Epilogue: Reining in the community care access centres
- 8.4.1 Romanow and the future of medicare
- 8.5 Whither the state in health care?
- References
- Index.